


//// 



Oniversity ol the State ol New York Bulletin 

Entered as second-class matter August a, 1913, at the Post Office at Albany, N. Y., under the 

act of August 34, 191a 

Published fortnightly 



No. 674 ALBANY, N. Y. November i, 1918 

SYLLABUS FOR THE EXAMINATION AND CENSUS 
OF MENTALLY RETARDED, SUBNORMAL, OR 
ATYPICAL PUPILS 

WITH AN OUTLINE OF SPECIAL CLASS ORGANIZATION 

The Legislature of 1917 enacted a law (Education Law, article 
20-B, section 578) providing for the education of children with 
retarded mental development. The essential provisions of this law 
are as follows: 

1 The law applies to each school district in the State and to each 
city in the State. 

2 It requires the trustees or board of education of each school 
district and the board of education of each city to take a census of 
the number of children in attendance upon the public schools under 
their supervision who are three years or more retarded in mental 
development. This census must be taken in accordance with regu- 
lations prescribed by the Commissioner of Education and approved 
by the Board of Regents. 

3 The board of education of each city and of each union free 
school district in which there are ten or more children who are 
retarded at least three years in mental development must organize 
special classes for such children. Not more than fifteen of such 
children may be in one class. Instruction must be provided which 
is adapted to the mental attainments of these children. 

4 A school district or city which has less than ten such children, 
instead of organizing a special class, may provide for the instruction 
of these children in any other city or district which has organized 
special classes for such type of children. 

It has been known for some time that there are large numbers of 
children in the schools who are retarded or below grade. Many of 
these are below grade for various reasons which may be overcome. 
Such children should be given the opportunity and assisted to a 
normal standard of work. There are also, of course, many other 
children who have not the mental capacity to do the school work 
of the average child. These children need special consideration also 
and very often a special type of instruction. There are still other 

G69r-Ja 19-3000 (7-1948) 



children who are not capable of mental development or of training 
in the schools, whose presence is a menace to the well-being of the 
school. 

This law contemplates that all these children shall be located; 
that special courses shall be provided for those who may be helped 
in the public schools, and institutional care for those who are not 
capable of mental development and who do not have proper home 
environment. 

The public, the school and the home must cooperate in this 
important phase of school work. The whole plan must be admin- 
istered with sympathy, with caution and with specific regard for 
the rights of every child. The public school must be of service to 
every child who is capable of being trained to become either wholly 
or partially self-supporting and who has a home which is able to 
give him proper care when not in school. When the school can no 
longer be helpful to a child of this type and the home can not give 
him the care necessary for the protection of society, the school must 
then be an agency to bring to the proper authorities knowledge of 
the necessity of providing for the care of such child, and to aid in 
the location of the child in a proper environment. 

The Legislature of 1918 made provision for organizing the schools 
of the State so that this phase of work might be inaugurated. Two 
specialists have been authorized for the Education Department and 
the Department desires to give to the school authorities in the 
various cities and villages of the State the benefit of the training 
and experience of these specialists. It will require a long period 
of careful, conscientious cooperation between the State and the local 
school authorities to make this statute efifective and to accomplish 
the great purpose which the Legislature had in mind in its enactment. 

In connection with the estabhshment of special classes a series of 
blanks have been provided by the State Department of Education, 
and it is requested that they be used in all cases where the teacher 
or other school of^cial has reason to believe the pupil is (a) back- 
ward, seriously retarded or mentally deficient, (b) sufficiently 
abnormal in conduct to interfere seriously with school work, or (c) 
shows other serious nervous symptoms. It is not expected that each 
city will immediately undertake to classify properly all the children 
in the schools. The clearly marked cases or those giving the 
greatest difficulty should be considered first. Following this, all the 
retarded children should be examined, so that within a given time 

'^ Of D. 
"'^'1 ' 5 1919 






every pupil needing special instruction and special treatment will 
be taken care of. 

These blanks are five in number as follows : ( i ) pedagogical 
record, (2) personal history, (3) physical examination, (4) psycho- 
metric test, (5) summary record. 

The pedagogical record should be filled in by the teacher, in 
cooperation, if necessary, with any other official. Properly filled 
out, this blank will be very helpful in differentiating the various 
general groups of retardation, classified by causes, as follows : 
(i) late entrance, or lack of attendance, (2) physical infirmity, or 
illness, (3) mental incapacity. The pedagogical record should be 
the first blank used, and the findings deduced therefrom will deter- 
mine the advisability of proceeding further and carrying out the 
remaining four parts of the examination. This blank may be util- 
ized also if it is desired to make a general school survey of the 
mentality of pupils from the pedagogical standpoint. 

The personal history blank should be filled in preferably by the 
school nurse who, through her special training combined with the 
fact that she is working in the field, seems particularly qualified to 
obtain the valuable data concerning the home, family and personal 
history. 

The physical examination blank may also be filled in by the school 
nurse under the direction of the physician or may be done entirely 
by the latter. 

The psychometric test records should be made by some person 
qualified to do such psychological work. If no such person is avail- 
able, the State Department of Education may be called upon to 
furnish the examiner. 

The summary record should be filled in by a qualified medical 
exkminer, or by a psychiatrist of a qualified mental clinic, or by the 
State Department of Education, after the data derived from the 
four other records have been considered. A copy of this blank is 
to be returned to the State Department of Education, Albany. It 
will be noticed that the word diagnosis appears only on the summary 
record. This has been done to safeguard the child and to make sure 
that no one is pronounced mentally deficient or feeble-minded, 
except after a medical diagnosis based on conclusive evidence. 

It should not be lost sight of that the information gained by use 
of these records is in the nature of a privileged communication, and 
should therefore be obtained tactfully and with a consideration for 
the feelings of the pupil and his family, and should furthermore be 
regarded as essentially confMential. 



It is suggested that the various parts of each record be kept in a 
folder or large envelop (9 x 12) which in turn should be kept in 
a filing cabinet located in the superintendent's office or other suitable 
place. These records may be filed alphabetically, by special classes, 
or in any other manner more suitable to each local situation. A 
cross reference card index by name of pupil would be of value. 

It is intended that the records should be preserved and used year 
by year in each case. In this manner a continuous history is 
obtained which will be of decided value to local school authorities, 
to the State Department of Education and to other agencies inter- 
ested in the subnormal child. 



I Pedagogical Record Blank 

[To be filled in by teacher] 

THE UNIVERSITY OF THE STATE OF NEW YORK 

THE STATE DEPARTMENT OF EDUCATION 

PEDAGOGICAL RECORD — MENTALLY RETARDED OR 
SUBNORMAL PUPILS 

Date 

City or village School 

Name Date of birth 

Address Mental age 

Age at date yrs mos 

Attendance regular or irregular 

Grades skipped Repeated 

Cause of irregular attendance 



Ever truant Cause 

Ever in court Cause 

Note any extraordinary circumstances unfavorable to progress, 
that is, ill health of child or of members of his family; foreign 
language spoken in home; undue amount of, or unsuitable labor 
outside of school; unfavorable home environment, etc. 

What physical defects are noted on medical card 



Underscore words that best describe the child : active, passive, 
moody, depressed, happy, ambitious, indolent, affectionate, sensitive, 
bold, cruel, destructive, insubordinate, peculiar, mischievous, ring- 
leader, quarrelsome, deceitful, lies, steals, sex offender, sex abnorm- 
ality, bad companions, 

State any peculiarity, disease or defect in any other member of 
the family. 



Give your reasons for the mental retardation. 



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8 

Suggestions for Pedagogical Inquiry or Survey 

To determine the nature of mental retardation a full and accu- 
rate pedagogical history is indispensable. Information should be 
obtained on just as many items as possible and should be as 
accurate as circumstances will permit. Most of this blank pre- 
sumably can be filled out by the teacher without entailing any undue 
time or labor, because the items called for are those ordinarily found 
in the individual record book or in the records kept in the principal's 
office. The item "mental age" can be filled in only as the result 
of the psychological examination. It should be written as a fraction 
in which the mental age is the numerator and the physical age is the 
:denominator. These should both be expressed in years and months ; 
example, -r^l which means that the child was 12 years and 3 months 
old when the psychological test was made and his mentality was 
equivalent to that of a child 6 years and 8 months of age. 

The pedagogical history form is designed to present in condensed 
form the principal facts of the child's school progress. When com- 
plete, the first column will indicate in what grade or grades each 
year of the child's life has been spent from entrance to date, and 
his general standing in each grade. The second column, " place," 
indicates in what school or schools the child has been from the age 
of six to the present. . The name of the teacher of each grade is 
called for because she is often able to furnish valuable data con- 
cerning the child's early years that may not be in the possession of 
the child's present teacher or of the principal. Inferentially this 
form furnishes the basis for estimating years of retardation. 

The pedagogical chart is designed to represent graphically the 
child's success or lack of success in his work. This form permits 
of a graph for each year if desirable, by paying careful attention tO' 
the date in the first column. Begin the graph line in the first column 
at the left in the date of record. By using dii?erent colored inks or 
by the differing character of the line (solid, dashed, dot and dash) 
several records at yearly intervals can be shown. This graph 
becomes very expressive by drawing a straight line across the form 
indicating the grade in which the child ought to be according to his 
chronological age. For example, a child 13 years old may be doing 
4A reading and 3B arithmetic, 4B spelling, 2B writing, etc. The 
graph then appears as an irregular line in the lower part of the 
form. Now draw a straight line through yA or 7B showing the 
approximate work he should be doing at 13 years. A glance tells 



that he is approximately from three to four years retarded in his 
pedagogical standing. 

The pedagogical chart is very helpful when interviewing parents 
as to the correct placing of a child in a grade and more especially 
in the special class, as it affords convincing proof of the child's 
retardation. 

In the column under " traits " are listed some of the most import- 
ant functions of mentality. The measurement of the pupil's 
intelligence is here amplified by an estimate of his " memory," 
"attention," and "practical judgment" (common sense) and his 
character by his " obedience," " self-control," " moral reactions," 
and " companionability." " Economic efficiency," representing 
combined functions of intelligence and character, means the pupil's 
practical ability to perform useful work. Very young children or 
those markedly defective possess very little, if any, economic effi- 
ciency. As a rule, economic efficiency progressively increases with 
age, and even defectives or subnormals by the age of 14 or 15 may 
develop to a level of self-support or at least partial self-support. 
The " traits " tabulated are not easy to evaluate. It is, however, 
requested that a rating be given each one on the basis of 5, in which 
I is lowest, 3 average and 5 highest, with the date on which the 
rating is made. An additional column is provided for subsequent 
ratings. 

It is desirable that the years of retardation be very carefully 
computed and that the method of computation be as nearly uniform 
as possible throughout the State. It is important to note that 
" being in a grade " is not an accurate criterion of a child's success 
or nonsuccess in school. Age of entrance into school and into 
the various grades is a fundamental basis for judgment. The fol- 
lowing tables will furnish a basis for computation. Table i indi- 
cates the standard age for beginning the work of each grade as 
adopted by the superintendents of the State of New York. 

Table 1 
Standard ages for beginning the work o£ each grade 



B 6 


yrs. 


but less than 


7 yrs. 


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but 


[ess than 11 y 


1 A 6^ 






71/3 




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115^ ' 


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B 11 




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10 

Table 2 

Dates of birth used in computing ages 

Age, September 15, 1918 

12-15-1912 to 6-14-1913= 5^/4 years 12-15-1906 to 6-14-1907=1 li/4 years 

6-15-1912 to 12-14-1912= 6 " 6-15-1906 to 12-14-1906=12 

12-15-1911 to 6-14-1912= 614 " 12-15-1905 to 6-14-1906=12^ " 

6-15-1911 to 12-14-1911= 7 " 6-15-1905 to 12-14-1905=13 

12-15-1910 to 6-14-1911= 7y2 " 12-15-1904 to 6-14-1905=13^ " 

6-15-1910 to 12-14-1910= 8 " 6-15-1904 to 12-14-1904=14 

12-15-1909 to 6-14-1910= SVi " 12-15-1903 to 6-14-1904=14i/4 " 

6-15-1909 to 12-14-1909= 9 " 6-15-1903 to 12-14-1903=15 

12-15-1908 to 6-14-1909= 91/ " 12-15-1902 to 6-14-1903=15^ " 

6-15-1908 to 12-14-1908=10 " 6-15-1902 to 12-14-1902=16 

12-15-1907 to 6-14-1908=10^ " 12-15-1901 to 6-14-1902=16i/4 " 

6-15-1907 to 12-14-1907=11 " 6-15-1901 to 12-14-1901=17 

Note: Age is figured to nearest birthday; for example, any child whose birth 
date falls between June 15, 19 12 and December 14, 19 12 is considered six years 
of^age, etc. 

Table 2 furnishes data for computing the child's age at the begin- 
ning of the current school year, September 15, 1918. Amount of 
retardation is found by comparing the age of a given child, as ascer- 
tained from table 2, with his proper grading as ascertained from 
table I. For example, John Doe was born August 7, 1909, and he 
entered second grade September 1918. Is he retarded and how 
many years? By table 2, John Doe's birthday will fall in the eighth 
line from top 6-1 5-1909 to 1 2-1 4-1 909 and his age is therefore 
estimated as 9 years. By referring to table i, a child 9 years old 
should be entering fourth grade in September and we estimate that 
John Doe is pedagogically two years retarded, provided that he 
entered the first grade when he was 6 years old and that his attend- 
ance has been fairly regular since entrance. 

Many factors enter into the question of retardation, all of which 
should be carefully weighed before rendering a final decision upon 
a child's candidacy for special class. But the careful statement of 
years of retardation furnishes a working basis for all who are called 
upon to make a partial diagnosis of the child. 

This blank may be used as the basis for the initial survey for the 
establishment of special classes. It will be well to include in the 
initial survey all children from first to eighth grades who are not 
making satisfactory normal progress through the grades. 



II 

2 Personal History Blank 

[To be filled in by school nurse or physician] 
THE UNIVERSITY OF THE STATE OF NEW YORK 

THE STATE DEPARTMENT OF EDUCATION 

Personal History Record — Mentally Retarded or Subnormal 

Pupils 



Date 

City or village School 

Name Sex Age . 

Address Nationality. . 

Parents [names] 



[Give (i) Parents' (and if possible grandparents') names, nationality, age, occu- 
pation, hai)its, treatment of children, attitude toward school, health and men- 
tality. 

2 Social status and general repute of family in community, the home, type of 
dwelling, hygienic and economic conditions, language spoken in home. 

3 Pupil's brothers and sisters, names and ages, in order (including stillbirths 
and miscarriages) , occupations, school record, health and mentality. 

4 Pupil's history. Developmental: gestation, birth; age of teething, walking 
and talking. Illness; accidents; play; conduct; attitude toward school; habits. 

For further suggestions and detail of record making, consult the Syllabus on 
Retarded Pupils.] 

Suggestions for Personal History Inquiry 

Give as complete data as possible concerning the following: 
parents' names, ages, consanguinity, birthplace, language spoken, 
length of time in this country, education, occupation, income ; habits 
(alcohol, drugs); criminal record; sex perversion; general health, 
tuberculosis, syphilis or gonorrhea, epilepsy, nervous or mental dis- 
ease. Describe mentality of father, mother; attitude toward the 
school ; treatment of the child — abused, indulged etc. 

Secure, if possible, the same data concerning grandparents. 

Social status of family; general repute in community. Ever 
receive public relief? Type and location of dwelling — tenement, 
detached house etc. ; hygienic and economic conditions — crowded 
dirty, untidy etc.; poverty, poor management etc. 

Pupil's brothers and sisters, names and ages given in order 
(including miscarriages and stillbirths, if possible to obtain this 
information), occupations, school record, health, and notes on 
mentality of each. If married, give married name and children. 
If any are deceased, give cause of and age at death. 

Pupil's own history. Give health of mother during gestation. 
Full-term child? Instrumental or difficult labor? Blue baby? 
Injury during labor? Convulsions then or later? Snuffles or other 
sign of syphiHs? Skin disease? Age of teething ? Second teeth? 



12 

Age and development of walking, talking. Malnutrition in infancy? 
Development of puberty, early, late, accompanied by abnormalities ? 

Illnesses: Rickets? Tuberculosis? Scrofula? Scurvy? Con- 
vulsions? Enlarged glands? Meningitis? Infantile paralysis? 
Epilepsy? Chorea or St Vitus dance? Scarlet fever? Measles? 
Diphtheria ? Typhoid ? Whooping cough ? Any trouble with ears, 
eyes, nose? Obstruction to breathing? Mouth-breather? Skin 
disease? SyphiHs? 

Accidents. Severe accidents, possibly contributing to or causing 
retardation ? 

Conduct. If any mental peculiarity is present, at what age did it 
manifest itself ? Hides, breaks or destroys things ? Ill tempered or 
good tempered? Emotionally unstable? Runs away from home? 
Attitude toward animals ? Conduct in home and elsewhere ? Atti- 
tude toward school? Any delinquencies? Court record? Habits? 
Sleep? Development and control of bladder and rectum? Per- 
sonal cleanliness? Any sexual abnormalities? Uses tobacco, alco- 
hol, drugs, excessive tea, coflfee ? Other bad habits ? 

Play. Kind of associates? With younger children? Attitude 
toward playmates? Other abnormalities of play? Describe kind 
of play? 

Capacities. Does child help in any way around the home ? In 
what way ? Work elsewhere ? What can the child do in a practical 
way? 



13 
3 Physical Examination Blank 

[To be filled in by school physician assisted by iiitrse] 
THE UNIVERSITY OF THE STATE OF NEW YORK 

THE STATE DEPARTMENT OF EDUCATION 

Physical Examination Record of Mentally Retarded or Sub- 
normal Pupils 

Date 

City or village School . 

Name 

Age Nationality Height Weight 

General appearance. Stigmata of degeneration. Deformities. 
Anthropometric data, if indicated. 

Nutrition 

Head Face 

Vision Eyes 

Hearing Ears 

Speech Mouth ; tonsils. Nose ; adenoids 

Teeth 
Gastro-intestinal 

Chest Heart Lungs 

Genitalia Sexual 

Skin Wasserman 

Neurological (reflexes, etc.) 
Remarks 

Physical Examination 

It is assumed that the subnormal child should have a particularly 
thorough physical examination. On this account a special blank 
giving more space for record, has been provided. 

If the child is unusually small or large or shows other marked 
deviation from the usual conformation it is then suggested that the 
commoner anthropometric measures be taken ; for example, breadth, 
length and circumference of head, and height sitting and standing. 
Stigmata of degeneration or any deformities should be carefully 
described. 

On the blank are enumerated as mere headings the physical fields 
of inquiry that are important in every special case. It is especially 
necessary that an examination as complete as possible be made of 
eyes, ears, mouth, nose, including tonsils and adenoids, and record 
made thereof. If no examination is made in any of the fields of 
inquiry, this fact should be stated on the blank. The reverse side 
of the blank may be used or additional plain sheets be appended in 
case the special physical examination requires more space. 



14 
4 Psychometric Test Blank 

THE UNIVERSITY OF THE STATE OF NEW YORK 

THE STATE DEPARTMENT OF EDUCATION 

PSYCHOMETRIC TEST BLANK 

Date 

City or village School 



Name Age, yrs mos 

Address Grade Mental age 

Birthplace Color Date of birth 

Nationality 

Examiner Examination requested by 

Reason of request 

Year 3 

I Points to parts of body (3 of 4) 

Nose Eyes Mouth Hair 

2 Names familiar objects (3 of 5) 

Key Penny Closed knife Watch Pencil 

3 Pictures (enumeration or better) 

a Dutch home 
h Canoe 
c Post office 

4 Repeats 6-y syllables (i of 3) 

a " I have a little dog." 

h "The dog runs after the cat." 

c " In summer the sun is hot." 

5 Give sex (note form of question) 

6 Gives last name 

Al. Repeats 3 digits (i of 3; order correct) 

Year 4 

1 Compare lines (3 of 3, or 5 of 6) i 2 3 

2 Counts 4 pennies (no error) 

3 Copies square (pencil, i of 3) i 2 3 

4 Comprehension, first degree (2 of 3) "What must you do: 

a " When you are sleepy ? 

b "When you are cold? 

c " When you are hungry ? " 

5 Discrimination of forms (Kuhlmann, 7 of 10) 

Errors 

6 Repeats 4 digits (i of 3, order correct, read i a second) 

4739 2854 7261 

Al. Repeats 12-13 syllables, (i of 3 absolutely correct or 2 with 
one error each) (a) " The boy's name is John. He is a very 
good boy." (b) "When the train passes you will hear the 
whistle blow." (c) "We are going to have a good time in 
the country." 



15 

Year 5 

1 Comparison of weights (2 of 3) 3-15 15-3 3-15 

2 Colors (no error) Red Yellow Blue Green 

3 Esthetic comparison (no error) 123 

4 Three commissions. Key Door Box 

5 Definitions, use or better (4 of 6) 

Chair Doll 

Horse Pencil 

Fork Table 

6 Patience (2 of 3, i minute each) 123 
Al. Age 

Year 6 

1 Right and left (3 of 3, or 5 of 6) R. hand L. ear R. eye 

2 Mutilated pictures (3 of 4) 

Eye Mouth Nose Arms 

3 Counts 13 pennies (i of 2 trials, no error) i 2 

4 Comprehension, second degree (2 of 3) " What is the thing 

to do: 
a " If it is raining when you start to school ? 
b " If you find that your house is on fire? 
c " If you are going some place and miss your car?" 

5 Coins (3 of 4) Nickel Penny Quarter Dime 

6 Repeats 16-18 syllables, (i of 3 correct or 2 with one error 

each) 
a " We are having a fine time. We found a little mouse in 

the trap." 
b " Walter had a fine time on his vacation. He went fishing 

every day." 
c " We will go out for a long walk. Please give me my 

pretty straw hat." 
Al. Morning or afternoon (note form of question) 

Year 7 

1 Fingers. R. L. Both 

2 Pictures (description or better) 

a Dutch home 
b Canoe 
c Post office 

3 Gives differences (2 of 3) 

Fly Stone Wood 

Butterfly Egg Glass 

4 Copies diamond (pen, 2 of 3) i 2 3 

5 Ties bow knot. Time Method 

6 Repeats 5 digits (i of 3, order correct) 

31759 42835 98176 

Al. Days of week. Mon. Tues. Wed. Thurs. Fri. Sat. Sun. 
Al. Repeats 3 digits backwards, (i of 3) 283 427 958 



i6 

Year 8 

1 Counts 20-0 (40 seconds, i error allowed) Time errors 

2 Comprehension, third degree (2 of 3) What is the thing for 

you to do: 
a Broken something 
b Danger of being tardy 
c Playmate hits you 

3 Gives similarities 

Wood Apple Iron Ship 

Coal Peach Silver Auto 

4 Vocabulary, 20 words Score Total vocab. 

5 Ball and field (inferior or better) 

6 Definitions, superior to use 

Balloon Football 

Tiger Soldier 

Al. Six coins. .05 .01 .25 .10 i.oo .50 

Al. Dictation. Time Score 

Year 9 

1 Date, a Day of week b Month c Day of month d Year 

2 Weights 123 

3 Repeats backwards 6-5-2-8 4-9-3-7 8-6-2-9 

4 Sentences 

a Boy, river, ball 
b Work, money, men 
c Desert, rivers, lakes 

5 Makes change: 10-4 15-12 25-4 

6 Rhymes : Day Mill Spring 
Al. Names months 

Jan. Feb. Mar. Apr. May June July Aug. Sept. Oct. Nov. Dec- 
Al. Stamps 

Year 10 

1 Vocabulary, 30 words. Score Total vocab. 

2 Absurdities, a b 

c d e 

3 Comprehension, fourth degree 

a 
b 
c 

4 60 words (score by half minutes) 

I. 2 3 4 5 6 

5 Designs 

6 Reading and report. Memories Time Mistakes 
Al. Repeats 3-7-4-8-5-9 5-2-1-7-4-6 

Al. Repeats 20-22 syllables, a be 

Al. Healy A. Form board. Time. 123 Method 



12 




Score 


Total vocab. 




Time 




Time 




Time 


d 




e 





6-9-4-8-2 



5-2-9-6-1 



17 

Year 

1 Vocabulary, 40 words. 

2 Dissected sentences 

a 
b 
c 

3 Fables a 

b 
c 

4 Repeats backwards 3-1-8-2-9 

5 Pictures, interpretation (3 of 4) 

a 
b 
c 
d 

6 Similarities 

a Snake, cow, sparrow 

b Book, teacher, newspaper 

c Wool, cotton, leather 

d Knife-blade, penny, piece of wire 

e Rose, potato, tree 

7 Abstract words: pity, revenge, charity, envy, justice 

8 Ball and field (superior plan) 

Vocabulary (the score is the number of correct definitions 
multiplied by 2) 



gown 

tap 

scorch 

puddle 

envelop 

rule 

7 health 

8 eyelash 

9 copper 

10 curse 

11 pork 

12 outward 

13 southern 

14 lecture 

15 dungeon 



16 skill 

17 ramble 

18 civil 

19 insure 

20 nerve 

21 juggler 

22 regard 

23 stave 

24 brunette 

25 hysterics 

26 Mars 

27 mosaic 

28 bewail 

29 priceless 

30 disproportionate 



Additional tests and notes on examination 



Psychometric Blank 

The psychometric testing should be done only by a qualified 
examiner. 

At the beginning of the four-page blank, space is provided for 
the child's personal data, the date on which the examination is made, 
the exact age of the child at that time, with the date of birth, and 
the mental age score. 



18 

Then follows an adaptation of the Stanford revision of the Binet- 
Simon intelligence scale for the years 3 to 12 inclusive. The tests 
are so arranged that the first four of each group, with the exception 
of year 12, may be given as an abbreviated scale, where time-saving 
is essential, each test having an evaluation of 3 months. In year 12 
the first six may be thus used, with an evaluation of four months 
each. Insert sheets may be used, care being taken that they are 
properly secured to the blank, for recording the pupil's reproduction 
of the square (4, 3), diamond (7, 4), the designs (10, 5), the ball 
and field (8, 5; 12, 8) and the free association (60 words) (10, 4), 
and also for notes on the examination and any other performance 
tests that may be applied. 



19 
5 Summary Record Blank 

THE UNIVERSITY OF THE STATE OF NEW YORK 

THE STATE DEPARTMENT OF EDUCATION 

SUMMARY RECORD — MENTALLY RETARDED OR 
SUBNORMAL PUPILS 

Date 

City or village School 

Name Sex Age 

Address Nationality 

Parents [names] 

1 Family history 

2 Environment 

3 Personal history 

4 Pedagogical history 

5 Social history and reactions 

6 Moral reactions 

7 Economic efficiency 

8 Practical knowledge and general information 

9 Pedagogical examination by 

10 Psychometric tests by 

11 Physical examination by , 

12 Psychiatric examination by 

Diagnosis by 

Confirmed by 

Disposition of case 

Summary Record 

This very important record is intended to summarize in the 
briefest possible manner the findings in the various fields of inquiry. 
It is only after the consideration of each of these fields that a 
diagnosis is made ; indeed in many instances it is the only safe way 
in which an opinion as to the mentality of the child can be formed. 

The blank is to be filled out only after the data on the pedagogical 
record, personal history, physical examination and psychometric test 
blanks have been obtained. Practically, the official making the 
psychometric tests will no doubt in cooperation with the school 
physician be qualified to pass judgment upon each field of inquiry. 
The diagnosis should be made by the school physician or if possible 
by a qualified psychiatrist. The scope and the main points to be 
determined in each of these fields is as follows : 

1 Family history. Is there sufficient evidence of feeble-minded- 
ness, insanity, degeneracy or other factors to warrant the assump- 
tion that the child is defective on a hereditary basis? 

2 Environment. Is the home or other environment so unfavor- 
able as to promote mental- and physical retardation and inferiority ? 



20; 

Consider repute of family, social status, quality of home, economic 
condition. 

3 Personal history. Does early history indicate " primary " (con- 
genital or hereditary) mental defect? Are there other known causes 
which may have produced the defect? Was this cause, or causes, 
engrafted upon an apparent normality? ("secondary" defect). 

4 Pedagogical history. Does this indicate that retardation is due 
to inherent or organic defect, or to other causes, irregular attend- 
ance, late entry, etc. 

5 Social history and reactions. This refers to the child's relation 
to his associates and his environment. The following topics bring 
out more clearly just what is considered under this heading: 
Obedient? Quarrelsome? Ill tempered? Teased? Easily influenced? 
Conduct in general? Amusements? Interests? Recreations? Asso- 
ciates ? 

6 Moral reactions. This field covers individual or innate traits 
of the moral or ethical sphere. Has the pupil moral sense? Does 
he lie, steal ? Is he egotistical, vain, selfish ? Has he sexual vices ? 
Does he know difference between right and wrong? Court record? 

7 Economic efficiency. Practical ability to perform any kind of 
useful work. Consider pupil's record, if he has ever worked for 
wages ? 

8 Practical knowledge and general information. Every-day 
matters of common knowledge and common sense, such as may be 
acquired independent of schooling. Contrasted with scholastic 
acquirements and intellectual ability. 

9 Pedagogical examination. Does this show sufficient retardation 
to warrant at least a tentative diagnosis of f eeble-mindedness ? 
(Three or more years of retardation, with full schooling.) 

10 Psychometric tests. Does the mental age level as determined 
by these tests indicate mental deficiency ? Give the mental_ age. _ 

11 Physical examination. Does the physical examination give 
supporting evidence of a diagnosis of mental deficiency? Briefly 
indicate main points. 

- 12 Psychiatric examination. Are there any evidences of a 
psychopathy? A qualified psychiatrist should evaluate this as well 
as the eleven preceding fields and arrive at a diagnosis. 

The information desired under each of the above headings may 
be expressed by a plus or minus, in which the minus sign means 
defect or subnormality. For example, the minus sign opposite 
" Family history " indicates that the family clearly shows evidence 
of mental deficiency or other factors producing subnormal offspring; 
opposite " Pedagogical history " it indicates that the pupil's school 
record furnishes convincing evidence of defect. The plus or minus 
sign, especially the latter, should not stand alone without some brief 
explanation as outlined above. 

As stated above, the diagnosis should be made by a psychiatrist 
of a qualified mental clinic, but in addition it is subject to review 
and confirmation by the State Department of Education. 



21 

There is space on the blank (using reverse side, if necessary) to 
record the disposition of the special case, whether special class, 
excluded, sent to institution, etc., and also for the subsequent history. 

A copy of each summary record is to be sent to the Physical and 
Mental Diagnostician, State Department of Education, Albany, 
N. Y. 

Suggestions in Organizing Special Classes 

1 The number of children in each class is limited by recent 
legislation to fifteen. 

2 Secure a teacher who has had special training, or secure one 
who will make special preparation at her earliest opportunity. Offer 
an additional salary in order to get the best teacher possible. ' 

3 Choose a sunny, cheery, well- ventilated room. Do not equip 
it with immovable desks. The combination desk-chairs with adjust- 
able desks are preferable as these can be pushed to the wall leaving 
space for physical exercises, industrial work, etc. As a temporary 
plan until funds can be obtained, use ordinary " kitchen " chairs. 
Adjust these to proper height by sawing off legs of some of the 
chairs and tables. Ideal equipment will furnish opportunity for the 
pupils to cook and serve themselves a hot lunch, to learn the rudi- 
ments of homekeeping, of cleanliness, etc. Plan for such ideal 
equipment and furnish it as fast as conditions will permit. 

4 Arrange the daily program so that only two-fifths of the day 
shall be given to the academic subjects, and limit these to sense- 
training, nature study, simple practical number work presented con- 
cretely, language and easy reading including stories, dramatization 
and elementary letter writing, simple drawing and painting with 
colored crayons and paints. Spend three-fifths of the day in hand- 
work, recreation and supervised play out of doors, gymnastics — 
corrective, setting-up exercises, rhythm work and folk dancing — 
rote singing, woodwork, industrial training and sewing, home- 
keeping, training in habits of cleanliness by caring for their personal 
appearance and the room. 

5 Furnish adequate materials for handwork, for industrial train- 
ing, for homekeeping, etc. Allow the teacher to assist in the selec- 
tion of materials as she may know how to use certain materials and 
not others. A trained teacher will know just what is needed. 
Remember that the mind and the body are both benefited by 
industrial training and handwork. 

6 Remember that the State Department of Education is more 
than willing to assist by suggestion and advice, by visitation and 
personal help, or by furnishing data on equipment, materials etc. 

We append a list of several books which will be found very sug- 
gestive and helpful : 

Anderson, Meta L. Education of Defectives in the Public 
Schools. World Book Co., Yonkers on Hudson, N. Y. (paper) 75c. 

Fitts, Ada M., & others. The Boston Way. Rumford Press, 
Concord, N. H. $1. 

Survey Committee of the Cleveland Foundation. Schools and 
Classes for Exceptional Children. Cleveland, Ohio. 25c. 



22 

Witmer, Lightner & others. The Special Class for Backward 
Children. Psychological Clinic Press, Philadelphia. $1.50. 

Ungraded. A monthly periodical published by The Ungraded 
Teachers Association of New York City, 500 Park av. $1.50 per 
annum. 

If these books are not found in your local library they may be 
borrowed, free of expense, from the State Library. Address Refer- 
ence Section, State Library, Albany, N. Y. A more complete 
bibliography covering the scientific and educational phases of mental 
defect is also available. 

In constructing our blanks and formulating our data upon the 
examination and record-keeping in cases of mental retardation, 
many authorities and publications have been consulted. We have 
freely availed ourselves of helpful suggestions obtained from the 
inspection of record blanks in use in this and other states. Owing 
to the difficulty in determining the originality of some of the material 
used, we can only express our indebtedness in blanket form to all 
those who have preceded us in this work. We wish, however, 
specifically to acknowledge the contribution made to mental diag- 
nosis by Dr W. E. Fernald (Mental Hygiene, i (1917) : 211; 
American Journal Insanity, 70: 253; Journal Psycho- Asthenics, 18: 
73) by his " Ten Fields of Inquiry." We have added two more 
fields : " Environment " and " Psychiatric Examination," not that 
they really present anything new but chiefly because they are needed 
on account of local conditions. We wish also to acknowledge help- 
ful suggestions from the work of the Child Study Laboratory, 
Rochester, N. Y. 

As far as we know, the table for the Pedagogical history is new. 
This seems to us valuable, as it gives at a glance the school history 
and record of the pupil — information that is primarily indis- 
pensable — in its chronological order, the natural sequence in which 
the history-taker thinks and operates. 

The general methods of psychiatric historj^-making, field-work 
investigation and the use of the " fields of inquiry," as applied to 
mentally backward and subnormal children in the schools is also, we 
believe, an innovation. 

Properly understood and used, we believe we have introduced a 
procedure of great value not only in correctly diagnosing the 
varieties of mental retardation but also in suggesting lines of treat- 
ment both educational and medical. 

W. B. Cornell M.D. 

Physical and Mental Diagnostician 

Eleanor A. Gray 

Supervisor of Special Classes 
Approved 

Thos. E. Finegan 

Acting Commissioner of Education 



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